Abstract
Left ventricular non-compaction (LVNC) is a rare form of cardiomyopathy, which leads to progressive heart failure, arrhythmias, and thromboembolic events. Due to variable clinical presentations, it is often misdiagnosed as another cardiomyopathy or asthma. Here we report a case of 50 year-old-male who had multiple emergency room visits for shortness of breath (SOB) which were treated acutely with bronchodilators for presumptive asthma exacerbations. Subsequently, a 2D, color flow transthoracic echocardiogram was performed, which revealed the presence of dilated cardiomyopathy, and a low LV ejection fraction. In addition, left ventricular trabeculation was greater than that anticipated, with prominent inter trabecular recesses, supporting the diagnosis of LVNC. A family history of early onset heart failure was present. This case is presented to help physicians consider non-compaction cardiomyopathy as an etiology in patients who present with SOB and low ejection fraction (EF).
Highlights
Non-compaction of the left ventricle is a congenital abnormality, occurring between 5 to 8 weeks of life, in which the myocardium fails to transform into compact
Non-compaction cardiomyopathy is usually diagnosed at a young age; a few cases have been reported in an older age group [3]
We present a case of a middle-aged African-American male presenting with dyspnea, treated as asthma exacerbation, but diagnosed with non-compaction cardiomyopathy and heart failure after echocardiographic evaluation
Summary
Non-compaction of the left ventricle is a congenital abnormality, occurring between 5 to 8 weeks of life, in which the myocardium fails to transform into compact. As a result the cardiac muscle takes a spongiform appearance with hypertrabeculation and deep recesses in the ventricular wall [1]. Left untreated, this defect in endomyocardial morphogenesis can result in a dilated cardiomyopathy & severe systolic dysfunction [2]. Non-compaction cardiomyopathy is usually diagnosed at a young age; a few cases have been reported in an older age group [3]. The clinical presentation varies from asymptomatic to arrhythmia, heart failure, and systemic embolism. We present a case of a middle-aged African-American male presenting with dyspnea, treated as asthma exacerbation, but diagnosed with non-compaction cardiomyopathy and heart failure after echocardiographic evaluation
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